AB0959 SECUKINUMAB SURVIVAL AND ASSOCIATED DEMOGRAPHIC CHARACTERISTICS IN PATIENTS WITH SPONDYLOARTHRITIS AND PSORIASIC ARTHRITIS IN A REAL CLINICAL SETTING
Authors: M. López I Gómez, U. Astigarraga Urkia, L. Ibarrola, I. Pineiro, J. Mendizabal, G. Sada Urmeneta, N. Del Val del Amo, I. Paniagua Zudaire, L. Garrido Courel, R. Gutierrez, L. Horcada, C. Fito-Manteca
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Secukinumab (SCK) is a human monoclonal antibody (IgG1) directed against IL-17A, approved for the treatment of plaque psoriasis, psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA). Data from randomized controlled clinical trials (RCTs) have shown that SCK has a low frequency of treatment discontinuation. We currently have little consistent data on long-term survival of SCK in patients with AxSpA and PsA in regular clinical practice. Therefore, we aimed to evaluate the drug retention of SCK in actual clinical practice, causes for discontinuation and factors associated with SCK suspension in patients diagnosed with PsA or AxSpA who receive or have received such therapy. <h3>Objectives</h3> We aimed to evaluate the drug retention rate, causes for treatment discontinuation and factors associated with SCK persistence in patients with AxSpA and PsA in a real clinical setting. <h3>Methods</h3> A retrospective cohort study was carried out including patients diagnosed of axSpA fulfilling the ASAS classification criteria and PsA fulfilling the CASPAR classification criteria. A total of 90 patients were included in the study treated with SCK between 2016 and 2022 in the rheumatology service of the Hospital Universitario de Navarra. All patients included started SCK at least 12 months before the data extraction. Drug survival in months was analyzed by Kaplan-Meier curves while predictive factors of discontinuation were evaluated using a Cox regression analysis. The reason of suspension was also recollected. <h3>Results</h3> We included 90 patients (46 AxSpA and 44 PsA). The mean age at diagnosis was 44.5 years (SD 11.1) and the mean age at SCK initiation was 51.6 (SD 11.4). The median time from diagnosis to onset of SCK was 4.2 months (IQR 9.8) (Table 1). Eighty-three (92.2%) patients were treated with one or more biologics prior to SCK, median number of previous biologics was 2 (IQR 0-5). The average treatment duration was 31.8 months (SD 75.1). The 1 and 2-year retention rates for SCK in the AxSpA group was 83 and 71%, respectively, while for the PsA group it was 69 and 52% respectively (Fig 1). Thirty-five (38.88%) patients discontinued treatment, 29 (82,85%) due to inefficacy, 1 (2,85%) by their own decision, 4 (11,42%) due to persistent mechanical pain and 1 (2,85%) due to neoplasia. The factors associated with lower risk of discontinuation were higher IMC (<i>p</i> = 0.025) and diabetes (<i>p</i> = 0.04). None of the other clinical variables evaluated had a statistically significant association with a lower or higher risk of discontinuation or discontinuation. No patient presented infections that required discontinuation of the drug. <h3>Conclusion</h3> SCK showed a very high retention rate in a population that has been previously exposed to several biological therapies both in AxSpa and PsA groups. According to previous reports <sup>[1]</sup>, cardiometabolic comorbidities such as obesity and diabetes appear to be associated with better SCK survival and therefore this drug could be an optimal therapy for patients with cardiometabolic risk factors. <h3>Reference</h3> [1]Sara Alonso, Ignacio Villa, Sabela Fernández, José L. Martín, et al. Multicenter Study of Secukinumab Survival and Safety in Spondyloarthritis and Psoriatic Arthritis: SEcukinumab in Cantabria and ASTURias Study. Front Med (Lausanne). 2021; 8: 679009. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.